Indian Journal of Pathology: Research and Practice

This letter to editor was directed to explore the underlying evidence behind the pathogenetic, diagnostic, therapeutic and prognostic role of age in diabetic peripheral neuropathy (DPN) in order to establish an interrelationship between physiology and pathology in the pathophysiology of DPN in its symptoms, signs, clinical presentation and impact on individual’s life.

Keywords: Age; Ageing; Older people; Geriatric neurology, Elderly.

Ameloblasoma comprises 1-2 % of all cysts and tumors occurring in jaw. Unicystic ameloblastoma is a less aggressive variant of ameloblastoma mainly seen in younger age group with impacted tooth in mandibular ramus area. In present case young male patient developed asympotomatic swelling with no impacted tooth in the region of canine – premolar with histological features of mural and intraluminal proliferation pattern of unicystic ameloblastoma. 

Keyword: Ameloblastoma; Odontogenic; Mural.

Primitive Polar spongioblastoma is a very rare histopathological entity characterized by bipolar tumor cells with palisading nuclei showing immunoreactivity for neuron-specific enolase. The entity was first described by Russell and Cairns in 1947. It is classified as a high grade glioma with a very poor prognostic outcome. However, similar histological profile is often seen in many neuroepithelial tumors, and this category was earlier excluded from the World Health Organization (WHO) classification raising the question of its existence as a tumour entity. Presently, it is included in WHO classification in the category of CNS tumour of uncertain origin. To our knowledge, only a few cases of Primitive polar spongioblastoma have been reported so far. The present case of a 65 yr old male clinically presenting with vomiting & altered sensorium. MRI findings were inconclusive suggesting a mass lesion in the temporal lobe & a presumptive diagnosis of tumoral bleed was given.

Keywords: Glioma; Neuroepithelial; Palisading; Spongioblstoma. 

Objective: To study the role of FNAC in the diagnosis of cysticercosis. Materials and Methods: Thirty patients with subcutaneous and intramuscular nodules having a differential diagnosis of tuberculous lymphadenopathy, reactive lymphadenitis, lipoma, neurofibroma and cysticercosis were included in the present study. Results: FNAC proved to be the definitive diagnosis in 13 cases where fragments of parasite bladder wall were seen. Histopathology confirmed the diagnosis. In the rest 17 cases, no fragments were observed in the FNAC smears and parasitic inflammation was suggested on the basis of other cytomorphological findings. Follow-up biopsy confirmed the diagnosis of cysticercosis. Conclusions: FNAC in cysticercosis is an easy , reliable ,cost effective non invasive outpatient procedure . The cytological diagnosis is conclusive in the cases where fragments of actual parasite are identified in the smears. However, in other cases, presence of a typical granular dirty background, eosinophils or/and histiocytes ,giant cells etc. Give an insight to the pathologist to consider this possibility. Definitive evidence on cytology obviates the need for histopathology.

Keywords: Cysticercosis; Fine needle aspiration cytology; Parasite. 

Context: Gastrointestinal polyps are common in children with juvenile polyps being the most common type, accounting for 90% of cases.[1] The reported incidence of juvenile polyposis syndrome is between 1 in 100,000-1 in 160,000.[2] Present study reviews histopathology, distribution and clinical manifestations of gastrointestinal polyps in children and significance of mucosal eosinophilia in Juvenile polyps. A comprehensive knowledge of these disorders is necessary for correct treatment and follow up. Aims: To study histology and distribution of intestinal polyps and to analyze significance of stromal eosinophilia in the pathogenesis of Juvenile polyps. Settings and Design: Three year retrospective and two year prospective study between May 2007 and April 2012. Methods and Materials: Forty two cases of gastrointestinal polyps in children were studied. Polyp size, number and location were noted. Association between stromal eosinophilia and age/size in case of juvenile polyps was studied. Statistical analysis: Chi square test (PSPP software) Results: There were thirty four solitary juvenile polyps, two multiple juvenile polyposis cases, three inflammatory polyps and three Peutz Jeghers polyps. Most common site was rectum and mean age was 6.7 years. Eosinophilic infiltration showed positive correlation with size and inverse correlation with age in juvenile polyps.Conclusions: Majority of polyps in children are solitary juvenile  polyps. Presence of significant eosinophilic infiltration of polyps may suggest a role of allergy in etiopathogenesis of juvenile polyps. 

Keywords: Eosinophilic infiltration; Gastrointestinal polyps; Pediatric polyps. 

Background: Thermoregulation and thermal perception was considered as two independent processes involved with perceiving hot or cold stimuli which reflected small-fiber dysfunction in diabetic peripheral neuropathy (DPN). Objective: To explore and synthesize the existing evidence for thermoregulation and thermal perception for their testing and treatment methods in DPN from a pathophysiological perspective. Methods: A systematic review of PubMed, CINAHL and Google scholar was done using search terms “thermoregulation, thermal-hot/cold” to identify relevant citations for their inclusion after a three-level scrutiny for data extraction and descriptive synthesis into evaluation and management. Results: Of the total 30 included studies, 16 studies were on thermoregulation (body temperature=4, cold immersion recovery=1, warm immersion recovery=1, bronchial cold reactivity=1, cold pressor response=1, heat evoked potentials=2, thermal biofeedback=1, thermography/thermometry=3, device-specific use=2) and five studies were on thermal perception thresholds, one study on cooling detection thresholds and one study on heat pain thresholds. There were seven studies on interventions (cucumin=1, lycopene=1, quercetin=1, resveratrol=1, tapentadol=1, bone marrow transplantation=1, trolox=1). Conclusion: Thermoregulation and thermal sensory perception were altered in DPN, which was evidently demonstrated as changes in temperature, responses to immersion, heat evoked potentials, thermal perception thresholds, and thermal pain thresholds during assessment, and was positively reflecting therapeutic effects, efficacy and effectiveness of variety of interventions. 

Keywords: Thermoregulation; Thermal sensory examination; Thermoreception; Diabetic neuropathy.